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How Telemedicine is Revolutionizing Care for Parkinson’s Patients

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By Jovanka JoAnn Milivojevic

Living far away from medical experts or having difficulty traveling to them can make it challenging for Parkinson’s patients to get quality specialist care.  Can telemedicine that uses live one-on-one video conferencing make a difference?  That’s what researchers wanted to know, so they conducted a study telehealth among Parkinson’s patients.

Broadly defined, telemedicine or telehealth refers to the exchange of medical information using electronic communications like two-way video, email, smart phones and other wireless tools. It can mean doctor-patient two-way consultations, remote reviews of diagnostic tests, remote monitoring of vital signs, text medication reminders and more. All of it is underway and in use by doctors, patients and other healthcare professionals.

The Penn Medicine team led by Jayne Wilkinson, MD, and Meredith Spindler, MD, conducted a randomized controlled trial in the Parkinson’s patient’s home or at a Veterans Affairs Medical Center near the patient. Dr. Wilkinson is the Associate Clinical Director, Parkinson’s Disease Research, Education and Clinical Center at the Philadelphia Veterans Affairs Medical Center, in Philadelphia. She and her team set up two-way video communications to provide for consults between neurologists specializing in movement disorders and VA Parkinson’s patients. The control group received usual, in-office care.

“During the telemedicine sessions, we did standard Parkinson’s history intakes and visual observations of motor tasks such as moving hands and legs,” she explained, “there was no difference in clinical outcomes between the control group and the telemedicine study group.”

That’s good news because, according to Dr. Wilkinson, only about 40 percent Parkinson’s patients see specialists. The pilot study suggests that more patients can get specialist care through telemedicine and that that care can be as medically valid as onsite visits.

The study group gave high marks to telemedicine for convenience and access. Patients can struggle for an hour to get dressed and into the car. Then there’s the commute, parking and the caregiver’s time to consider. Telemedicine makes patients and their caregiver’s lives easier.

Older Patients Embraced the Technology 

It’s also interesting to note that the average age of the study participant was 73. There was no resistance to using the technology. Rather, they embraced it – technical glitches and all.  Dr. Wilkinson credits the VA for being pioneers in the use of telemedicine in general and specifically for Parkinson’s. This pilot study is the largest to date to evaluate telemedicine in this Parkinson’s patient population. The VA provided the equipment and tech staff to make it happen. The VA also recently approved the use of patient’s computers and tablets for telemedicine visits.

 “Seeing the patients in their homes and when they’re on vacation is very helpful,” says Dr. Wilkinson. “Instead of just talking to me on the phone, if they’re having a tremor they can show it to me.”

 The next step for Wilkinson and her team is to expand the pilot study to include VA centers nationwide. There are also plans to expand Parkinson’s caregiver support groups into the telemedicine model. While the VA has offered these in centers, attendance has been low. Caregivers may not be able to leave their loved ones at home to attend dedicated support groups.  Telemedicine makes it more feasible.

In related news, The Federation of State Medical Boards (FSMB) recently passed a new telehealth policy that allows for flexibility in the use of new technologies for virtual visits with physicians as long as they meet the standard of care. According to the FSMB, telehealth encounters should be HIPAA compliant, include informed consent, the generation of a medical record, and support continuity of care.

Insurance coverage for telehealth will vary according to plans and providers. A defined and accepted state board policy paves the way for greater acceptance and integration into healthcare policy and insurers nationwide. It’s a welcome way to extend access to care, especially to patients with chronic conditions.

Jovanka JoAnn Milivojevic develops health and medical content for a variety of clients nationwide. She is the author of The Complete Idiot’s Guide to Back Pain and contributing editor of the Essential Guide to Healthy and Healing Foods. As certified fitness professional, she teaches Pilates, yoga and dance. She blogs about healthy living at JoAnnMilPilates.com.